Individual
SHANNON O'ROURKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-7282
Mailing address
2130 W BRITTANY LN APT 100, BOISE, ID 83702-0680
(509) 699-1899
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P8436
ID
Other
Enumeration date
12/13/2019
Last updated
12/13/2019
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